LET'S TALK AGING: Signs and stages of dementia

Tuesday

May 16, 2017 at 12:01 AMMay 16, 2017 at 2:04 PM

Barbara Harrison

Having a map to guide you to a new location can make the journey a little less stressful. Likewise, when dementia is involved, getting an idea of where you are and what to prepare for can make the journey feel more manageable.

Dementia isn’t a disease itself. It’s a collection of symptoms that occur as a result of a condition or disease, such as Alzheimer’s or Parkinson’s. For some people, the progression of symptoms is rapid, and for some it’s slow—a lot depends on the underlying cause. While stages and correlating symptoms are typically similar between the various types of dementia, each person’s experience will be unique.

Early on

At the onset of symptoms, a person may begin having greater difficulty retrieving words, remembering names when meeting new people and keeping track of belongings. They may struggle increasingly with planning, organization, concentration and performing tasks in work or social settings. It’s also common for people in the early stages of dementia to develop depression or experience other changes in mood or disposition.

For most people, the early stages of dementia come with mild cognitive impairment. Many people can function independently, and some may even be able to continue driving or working.

Tips

The early stages of dementia are an ideal time to begin a discussion with your loved one about his or her wishes for the future. Legal, financial and medical directives are best reviewed at this time.

Mid-stage

For most people, the middle stage of dementia is the longest—in some cases, it can last for many years. In this stage individuals may have greater difficulty performing everyday tasks such as paying bills, dressing themselves and other activities relating to self-care. They may also display more frequent memory lapses that at this point that are also noticeable to others—they may have trouble recalling their own or another person’s personal history, addresses, phone numbers, etc.

You may also notice that your loved one has started to withdraw from social engagement or that they become anxious and irritable in socially or mentally challenging situations. Sudden mood swings and other behavioral changes like shifting sleep patterns or compulsive behaviors may start to become common.

Tips

In this stage, accurate diagnosis of Alzheimer’s disease is possible. Consult your healthcare team about increasing symptoms and schedule a medical interview; your doctor will be able to detect clear-cut difficulties and provide guidance on the best treatment going forward. With cognitive functioning declining progressively in this stage, individuals will require increased assistance with daily activities and self-care. This is the time to assemble your caregiving team—talk to friends, family and neighbors to let them know about progressing symptoms, and ask for help with organizing and managing caregiving tasks. This is also a good time to start researching and discussing long-term care options.

Late-Stage

As a person enters the later stages of dementia, their ability to communicate and respond to what’s going on around them deteriorates, as does control over movement. Individuals in this stage of dementia typically need round-the-clock care, including assistance with bathing, dressing, eating and other daily activities. They may experience difficulty walking or even sitting, and for some it can become difficult to swallow, which can present challenges at mealtime. It’s also not uncommon for people in late-stage dementia to become more vulnerable to infections, particularly pneumonia.

Tips

Although your loved one may struggle with using words, it helps if you can interact with gentle listening and acknowledgement. As a caregiver, it can be a challenge to be patient and encouraging. This is an important time to make sure you’re tending to your own needs and doing things to reduce your stress to make sure you have the necessary reserves for your loved one.

During late-stage dementia, the focus should be to make your loved one as comfortable as possible—calming music, aromatherapy, hand and foot massages, and as much extra TLC as you can provide are all helpful.

Barbara Harrison is executive director at Bridges by EPOCH at Pembroke, a memory care assisted living community that will open in fall 2017. She can be reached at bharrison@bridgesbyepoch.com.